Oral Management Improves Patient Outcomes in Hematopoietic Stem Cell Transplantation.

Introduction and aimsOral bacteria influence bloodstream infections in hematopoietic stem cell transplantation (HSCT). We investigated the effects of oral health management and its relationship with medical care delivery systems.MethodsPatients aged >16 years who underwent HSCT, discharged from Japanese acute care hospitals between April 2018 and March 2022, were categorized into autologous and allogeneic HSCT groups. Multivariable analysis assessed the impact of peri-HSCT oral management on antibiotic use, narcotic injections, and mortality rates.ResultsWe included 12,248 patients, 5936 autologous and 6312 allogeneic HSCT patients, across 298 hospitals. The defined daily dose (DDD) of antibiotic use within 14 days post-transplantation in the oral and nonoral management groups for allogeneic HSCT patients was 34.10 (standard deviation [SD] 20.35) vs 36.37 (SD 21.33); broad-spectrum antibiotics use was 23.87 (SD 15.82) vs 24.45 (SD 15.76). Within 30 days post-transplantation, the DDD of antibiotic use was 69.13 (SD 40.18) vs 75.16 (SD 43.47) was 45.70 (SD 29.63) vs 47.95 (SD 30.48), respectively. In allogeneic HSCT patients, oral management resulted in lower DDD of antibiotic use by 2.66 within 14 days and 6.74 within 30 days post-transplantation, after adjustment for relevant factors. Broad-spectrum antibiotic use within 30 days post-transplantation showed a lower DDD by 2.79 (P ConclusionEnsuring an appropriate oral environment for allogeneic HSCT patients helps preventing infection, extending life expectancy, and alleviating pain.Clinical relevanceCoordinated care between dental and medical teams is essential to deliver safe, personalized, and high-quality patient outcomes during HSCT.